Tobacco License Questionaire / Distributor Reporting Requirements (Page 2 of 5) in pdf

Definition(s) of Distributorship Type:

Cigarette Distributor: a distributor

of cigarettes without stamps affixed

(purchaser)

(prior to

and who is required to be licensed under section §42-

affixing the Arizona tax stamps for distribution)

3201.

Cigarette Manufacturer: a distributor who manufactures, fabricates, assembles, processes or

labels a finished cigarette and who is required to be licensed under section §42-3201.

Cigarette Importer: a distributor who directly or indirectly imports into the United States a

finished cigarette for sale or distribution and who is required to be licensed under section §42-

3201.

OTP Distributor: distributes Other Tobacco Products and/or purchases and distributes cigarettes

with Arizona tax stamp already affixed.

Read and Initial each paragraph acknowledging that you have read and understand the

reporting requirements for this license, if you have any questions please call (602) 716 – 6458.

_____ Any and all violations of any statute under Arizona Revised Statutes (A.R.S.) Title 36,

Chapter 6, Article 14; Title 42, Chapter 3; Title 44, Chapter 27, or of any rule under Title 15,

Chapter 3, of the Arizona Administrative Code (A.A.C.), may result in the revocation of your

Arizona Distributors license in addition to seizure of any and all untaxed tobacco products and all

applicable fines. All of the statutes and codes cited in this questionnaire can be accessed through

the Arizona Department of Revenue’s website at

Directory of Cigarettes (including roll your own tobacco) Approved for Stamping and Sale:

_____ Pursuant to A.R.S. §44-7111, it is unlawful for any person to (1) affix a stamp to a package or

other container of cigarettes of a "tobacco product manufacturer" or "brand family" or (2) to sell,

offer or possess for sale in this State any and all cigarettes (including roll-your-own tobacco)

NOT listed in the Directory. The Directory is maintained on the Attorney General's website at

The directory is divided by Participating Manufacturer’s and Non-Participating Manufacturer’s.

_____ Participating Manufacturer’s have agreed to and signed the Master Settlement Agreement as

listed on the National Association of Attorney General (NAAG) web site,

_____ All activity of buying and selling product from Nonparticipating Manufacturer’s MUST be

reported on the appropriate Nonparticipating Manufacturer’s Schedules. If there is no

Nonparticipating Manufacturer activity to report, then the Certification for No

Nonparticipating Manufacturer's Activity MUST be completed, signed and submitted with

report(s).

E-mail Address:

_____ A.R.S. §44-7111(3)(b)(5) requires that every distributor provide, and update as necessary, an

electronic mail address for the purpose of receiving notifications as may be required by this Article.

Provide your e-mail address:

(Example: )

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